Individual provider Active NPI

Vanessa Andricola

  • Pharmacist
  • Audubon, NJ
National Provider Identifier
1154776920
Registry record updated Apr 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
28RI02897400 Issued in NJ
Practice address
Rte 168 and Black Horse Pike
Audubon, NJ 08106
Phone
(856) 547-4076
Fax
(856) 310-1507
NPI assigned
Apr 29, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 28RI02897400 NJ Primary

Addresses

Primary practice location

Rte 168 and Black Horse Pike
Audubon, NJ 08106

Mailing address

Rte 168 and Black Horse Pike
Audubon, NJ 08106
Phone (856) 547-4076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
28RI02897400NJMDPharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1461888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461888000000",
    "number": "1154776920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RTE 168 AND BLACK HORSE PIKE",
            "city": "AUDUBON",
            "state": "NJ",
            "postal_code": "08106",
            "telephone_number": "856-547-4076",
            "fax_number": "856-310-1507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "RTE 168 AND BLACK HORSE PIKE",
            "city": "AUDUBON",
            "state": "NJ",
            "postal_code": "08106",
            "telephone_number": "856-547-4076",
            "fax_number": "856-310-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDRICOLA",
        "first_name": "VANESSA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-29",
        "last_updated": "2016-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NJ",
            "license": "28RI02897400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Audubon, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.